Finally, the long-awaited event has occurred -- the publication of "Transgender Care: Recommended Guidelines, Practical Information & Personal Accounts," by Gianna Israel and Donald Tarver, MD. (1997, Temple University Press). I have especially awaited it as a member of the review committee and an invited contributor. I will however, attempt to present an objective review and assessment now and devote next month's column to the subject on which I wrote an essay, the ethical dilemma in doing psychotherapy with transsexuals seeking genital reassignment.
This book is truly one-of-a-kind, a compilation of information about mental health issues, hormone protocols, and genital as well as cosmetic surgery. The needs of culturally diverse populations, youth and HIV positive consumers are examined and a bonus section of essays about rarely addressed issues adds the final fillip.
The book takes care to define terms up front in order to minimize repetive and distracting asides in the body of the work. I am especially grateful for the authors' introduction of the term "Gender Specialist" and a description of the areas of expertise such a professional has mastered. Until I had the opportunity to talk with Ms. Israel about this project several years ago, I had never heard the term. Now I define myself as such.
In an informal survey of several colleagues who have read the book, the section on mental health was considered comprehensive and practical. Definitions of diagnoses frequently applied to transgenders are listed and explained in easy to understand language. A physician friend praised the chapter on
Genital Reassignment Surgery as being the first he'd read dealing with insurance benefits, procedures, and how to assess a surgeon's skill and credibility, all in one place.
My favorite section is the Essays because it gives voice to many subjects heretofore rarely addressed in print. That is not to say that these issues are unknown. I have debated the subject I on which I wrote with many professionals but never before had a forum for publication. Other interesting issues raised in this section are whether Gender Specialists should be required to endorse desired hormonal and surgical treatment, the legal aspect of insurance reimbursement, and a comprehensive description of San Francisco's law against discrimination on the basis of gender identity.
This book is a major contribution to the literature on the the subject of transgender needs and a successful effort to serve the interests of professionals and consumers in one volume.
Dr. Anderson is located at 1537 Franklin St, Suite 104, San Francisco, CA 94109, 415-776-0139.